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目的探讨2型糖尿病患者有关的生物心理因素。方法对90例2型糖尿病患者和30名正常人进行明尼苏达多相人格调查表(MMPI)、多伦多述情障碍量表(TAS)、汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、社会支持量表(SS)等评定,测定血浆促肾上腺皮质激素(ACTH)、血小板5-羟色胺(5-HT)、血清白介素(IL)6(IL-6)及SIL-2R水平,并检测患者空腹血糖(FBG)、早餐后2h血糖(2PBG)和糖化血红蛋白指数(HbA1c)水平。将患者随机分为常规治疗组(常规组,45例;采用格列吡嗪7.5-15 mg／d)和常规治疗加帕罗西汀治疗组(合用帕罗西汀组,45例;采用格列吡嗪7.5~15 mg／d和帕罗西汀20 mg／d),治疗2个月后(两组分别失访4例和9例)观察患者上述量表评分、实验室指标的变化及其与FBG、2PBG、HbA1c等指标变化的关系。结果(1)治疗前,与正常对照组比较,患者组TAS、HAMD、HAMA总分高,SS总分较低(P<0.05),MMPI提示人格偏移;血浆ACTH、血清IL-6、SIL-2R及FBG浓度高,血小板5-HT浓度低(均P<0.01和<0.05)。(2)治疗后,合用帕罗西汀组的HAMD分、HAMA分、ACTH、IL-6以及糖代谢指标的改善程度均优于常规组。(3)患者组的HAMD减分率与ACTH变化率(r=0.37)及IL-6变化率(r=0.40)均呈正相关,HAMA减分率与ACTH变化率(r=0.41)呈正相关(均P<0.01);FBG下降率与H
Objective To investigate the biophysical factors related to type 2 diabetes. Methods Ninety patients with type 2 diabetes mellitus and 30 normal subjects were assessed with Minnesota Multiphasic Personality Inventory (MMPI), Toronto Symptom Checker Scale (TAS), Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA) Social Support Scale (SS) was used to measure the levels of plasma ACTH, 5-HT, IL-6 and SIL-2R, Fasting blood glucose (FBG), 2h postprandial blood glucose (2PBG) and glycosylated hemoglobin index (HbA1c) levels. The patients were randomly divided into routine treatment group (conventional group, 45 cases; glipizide 7.5-15 mg / d) and conventional treatment with paroxetine treatment group (paroxetine group, 45 cases; glipizide 7.5 ~ 15 mg / d and paroxetine 20 mg / d). After treatment for 2 months (4 cases and 9 cases lost in each group), the changes of laboratory scale, laboratory indexes and FBG, 2PBG, HbA1c and other indicators of changes in the relationship. Results (1) Before treatment, the scores of TAS, HAMD and HAMA were higher and the scores of SS were lower (P <0.05) than those of the normal control group. MMPI suggested the deviation of personality; the levels of plasma ACTH, serum IL- -2R and FBG concentrations were higher and platelet 5-HT concentrations were lower (both P <0.01 and <0.05). (2) After treatment, HAMD score, HAMA score, ACTH, IL-6 and glycometabolism in paroxetine group were better than those in routine group. (3) There was a positive correlation between the reduction rate of HAMD and the rate of change of ACTH (r = 0.37) and IL-6 (r = 0.40) in patients group. The reduction rate of HAMA was positively correlated with the rate of ACTH (r = 0.41) All P <0.01); FBG descent rate and H